Gloocal Communication : Rheumatoid Arthritis affecting youngsters

Rheumatoid Arthritis affecting youngsters

Zeenia Baria,TNN | Dec 29, 2014, 12.00 AM IST

Experts say that there has been a steady rise in the number of youngsters suffering from Rheumatoid Arthritis (RA), with incidences of cases being reported on a daily basis.

What is Rheumatoid Arthritis (RA)?
Orthopaedic and joint replacement surgeon Dr Hitesh Kubadia says that RA is not an inherited disease. "Researchers believe that some people have genes that make them susceptible to the disease. Those with these genes will not automatically develop rheumatoid arthritis. There is usually a 'trigger,' such as an infection (often viral infection) or environmental factor, which activates the genes. When the body is exposed to this trigger, the immune system responds inappropriately and instead of protecting the joint, begins to produce substances that attack the joint. This is what may lead to the development of RA," he says.

Causes:
- Dr Parul R Sheth, a health consultant specialising in reproductive biology says that RA is an autoimmune disease in which for an unknown reason, your immune system attacks the lining of membranes that surround your joints resulting in destruction of cartilage and bone within the joint. "Mutated genes may make you more susceptible to the disease. You can be more prone to RA if you are a woman. Family history, cold temperatures, humidity, or certain foods such as meat, foods containing saturated fat etc. can all trigger the disease," she says.

Treatment
Experts say there is no cure for RA but medication can reduce joint inflammation, relieve pain and slow or prevent the joint damage. "Occupational and physical therapy can help protect joints from further damage. Certain exercises can keep your joints flexible. In case medications or other treatment procedures fail, one may require surgery such as joint fusion or tendon repair or total joint replacement. You can try fish oil supplements to reduce pain and stiffness but talk to your doctor before taking them. Exercises can ease your symptoms, especially Tai Chi, which involves exercises and stretches combined with deep breathing. Ginger, green tea and turmeric are known to help. One should also try eliminating foods that may be triggering your symptoms," advises Dr Sheth.

"The aim of treatment is to attain remission. A treatment plan is tailored to suit a patient's needs and lifestyle. Usually, a team, of experts is involved. These include rheumatologists, physical and occupational therapists and orthopaedic surgeons. Juvenile RA is known to have genetically complex traits in which multiple genes are important for disease onset and manifestations, and it is characterised by arthritis that begins before the age of 16 years, persists for more than six weeks, and is of unknown origin," adds Dr Kubadia.

Winter worsens symptoms
- While the exact reason for this is unknown, it is believed that the change in atmospheric pressure tends to produce changes in the joints and tissues fluid balance, causing them to stiffen and cause pain. "A lot of the rheumatic conditions I treat become worse with a sedentary lifestyle — a condition that is more prevalent in the winter months. Many people lead a less active lifestyle and are feel low. This causes a subtle laziness to creep in and their joints tend to stiffen up. Cold weather tends to create lifestyle conditions that can lead to arthritic symptoms. To ease discomfort, the simplest advise is to get moving. Outdoor activities, indoor exercise and staying motivated to continue being active are important aspects. Also, maintaining hydration levels is as important as is in summer, for with every breath you breathe out, water droplets get exhaled from your system," ends Dr Kubadia.

GLOOCAL COMMUNICATIONS | World Anti-Obesity Day: Common weight loss diet myths busted

World Anti-Obesity Day: Common weight loss diet myths busted

On the eve of World Anti-Obesity Day, Hassan M Kamal looks into some of the most common weight loss diet myths, and why an improved lifestyle is as important as changing one's diet plan

Myth 1: Fat is always bad
Truth: Fat is the most misunderstood nutrient. A combination of healthy fats in the form of olive oil, rice bran oil, extra virgin coconut oil and omega 3 rich oils are healthy. Small amounts of saturated fats in the form of pure ghee is also acceptable. "The trans fats (vanaspati or hydrogenated vegetable oils and margerine) in the form of processed sodium-rich packaged foods are the killers which should be avoided, no matter what," says Tripti Gupta, lifestyle nutrition consultant and founder of iPink.

Myth 2: Carbohydrates make you gain weight
Truth: While there are plenty of diet regimes that promote low-carb food, so far, there's no proof that healthy carbohydrates are more likely to make one gain weight. In fact, it's an excess in calories that's responsible for weight gain. If you consume more calories than you burn in a week, you are more likely to gain weight, irrespective of where the calories come from. The goal should always be to eat in moderation.

Myth 3: Eating more protein can help lose weight
Truth: Anything in excess is bad, even if it's one of the most healthiest foods. You can't just gorge on eggs, sprouts or chicken and expect weight loss. Excess consumption of protein without backing it up with physical activity can, in fact, cause weight gain. "A balance of nutrients is the need of your body. Healthy weight loss can be achieved and sustained in the form of fat loss that has been attained as a consistent lifestyle correction," reminds Gupta.

Myth 4: Fruit juices help in weight loss
Truth: Fruit juices are calorie-dense drinks. You get more phytonutrients that may be present in fruits since you are squeezing more fruit to prepare a glass of juice. You are also consuming a fructose-rich drink. Besides, since the fibre is strained out and thrown away, you deprive yourself of fibre, one of the best parts of a fruit. Choosing whole fruits with fibre is a wise decision for dieters and the calorie-conscious. In fact, fruit juices can be administered for gaining weight. 

Myth 5: Bananas, rice and potatoes are fattening foods
Truth: These are very much a part of our natural healthy food groups and not to be treated as junk foods. Making a hue and cry about potatoes and rice does not make sense if you are guzzling down mugs of beer and eating sodium-rich diet farsan. Eat all food groups wisely, and you won't find these fattening.

Myth 6: Don't drink water while eating meals
Truth: This is the most commonly circulated myth. Water is the key for digestion, transportation of nutrients and effective absorption. Let's make it simple; think of your stomach as a mixer-grinder, which has to churn the ground food and get it ready to further break down for absorption. If your meal comprises thin dal, curries, buttermilk, with plenty of fluids to churn, your body may be able to do without water. But with today's lifestyle where we carry dry lunches to work such as roti with dry vegetables, and vegetable sandwiches, you will need to back it up with enough fluids.

Myth 7: Whey protein and supplements are pro-youth
Truth: Whey protein is very highly misunderstood. It's simply a muscle-building, quick-absorbing simplified form of amino acid, which is most effective in muscle repair. A basic whey supplement is not necessarily used to build muscles but to help you meet the protein requirements, especially since Indian meals are largely carbohydrate-based. As one gets older, the protein requirement increases and muscle-wasting speeds up. Hence, it's even more important for senior citizens to incorporate suitable whey protein supplements to help repair muscle, gain strength and maintain good stamina and health. It can be used correctly with any meal to meet your protein requirements for the day.

Myth 8: Fat burners and mono diets is the short cut to quick weight loss
Truth: Gaining and losing weight is the normal behaviour of human body but going for "fad diets" and pills for temporary weight loss is foolish. You can't achieve fat loss through these fat burners; in fact, they make you lose muscle and water, and fool you into temporary results you begin to believe in.

Myth 9: Eating organic food is healthier 
Organic foods are better for the environment as they are grown in natural environments and doesn't contain residues of the modern-day pesticides. But eating them doesn't necessarily mean you are consuming less calories. Organic cake, juices, chocolates and biscuits contain as much fat, sugar and salt as their non-organic counterparts. Don't be fooled by the label. The term 'organic' refers to farming methods used to produce a food item, and not to the nutrients found it. 

Myth 10: Dieting is enough to lose weight
"Overweight and obesity are misunderstood words. It is a chronic condition and there is no 'quick-fix' solution or treatment that is effective for all overweight or obese individuals," says Dr Manish Motwani, consultant bariatric surgeon, Jaslok Hospital. "Lifestyle modification (with a reduction of calorie intake and an increase in physical activity) is essential in all treatment strategies. All long-term programmes require at least some lifestyle changes. Positive changes in eating and exercise behaviour are essential for sustained reduction in weight. However, if you are extremely overweight you may have to undergo bariatric surgery," suggests Dr Motwani.

Other common weight-loss myths

>> Food eaten at night stops you from losing weight. Wrong. It’s not eating in the evening that stops losing weight, but eating in excess. In the end, it’s all about maintaining a zero balance in the calories and consumption sheet.

>> People inherit obesity: While scientists believe that children inherit obesity genes from their parents, it doesn’t explain how there is a sudden increase in obesity in the population. While genes have a role to play, our sedentary lifestyle is more responsible than the genes.

>> Cereal bars are lower in fat and sugar than chocolate or sweets. Wrong again. If you check the ingredients and calorie chart in a cereal bar, you will find just as much sugar as in chocolate. Read the nutrient chart before you buy any cereal bars.

>> Following a diet is not a punishment but simply a correction in your lifestyle and food choices. Whether at home or out, choosing wisely is the best option. Steamed or grilled foods, green salads and clear soups are wiser than eating homemade bhajiyas and chaats

- See more at: http://www.mid-day.com/articles/world-anti-obesity-day-common-weight-loss-diet-myths-busted/15791205#sthash.Ssvf9vSp.dpuf

GLOOCAL COMMUNICATIONS | World Anti-Obesity Day: Common weight loss diet myths busted

World Anti-Obesity Day: Common weight loss diet myths busted

On the eve of World Anti-Obesity Day, Hassan M Kamal looks into some of the most common weight loss diet myths, and why an improved lifestyle is as important as changing one's diet plan

Myth 1: Fat is always bad
Truth: Fat is the most misunderstood nutrient. A combination of healthy fats in the form of olive oil, rice bran oil, extra virgin coconut oil and omega 3 rich oils are healthy. Small amounts of saturated fats in the form of pure ghee is also acceptable. "The trans fats (vanaspati or hydrogenated vegetable oils and margerine) in the form of processed sodium-rich packaged foods are the killers which should be avoided, no matter what," says Tripti Gupta, lifestyle nutrition consultant and founder of iPink.

Myth 2: Carbohydrates make you gain weight
Truth: While there are plenty of diet regimes that promote low-carb food, so far, there's no proof that healthy carbohydrates are more likely to make one gain weight. In fact, it's an excess in calories that's responsible for weight gain. If you consume more calories than you burn in a week, you are more likely to gain weight, irrespective of where the calories come from. The goal should always be to eat in moderation.

Myth 3: Eating more protein can help lose weight
Truth: Anything in excess is bad, even if it's one of the most healthiest foods. You can't just gorge on eggs, sprouts or chicken and expect weight loss. Excess consumption of protein without backing it up with physical activity can, in fact, cause weight gain. "A balance of nutrients is the need of your body. Healthy weight loss can be achieved and sustained in the form of fat loss that has been attained as a consistent lifestyle correction," reminds Gupta.

Myth 4: Fruit juices help in weight loss
Truth: Fruit juices are calorie-dense drinks. You get more phytonutrients that may be present in fruits since you are squeezing more fruit to prepare a glass of juice. You are also consuming a fructose-rich drink. Besides, since the fibre is strained out and thrown away, you deprive yourself of fibre, one of the best parts of a fruit. Choosing whole fruits with fibre is a wise decision for dieters and the calorie-conscious. In fact, fruit juices can be administered for gaining weight. 

Myth 5: Bananas, rice and potatoes are fattening foods
Truth: These are very much a part of our natural healthy food groups and not to be treated as junk foods. Making a hue and cry about potatoes and rice does not make sense if you are guzzling down mugs of beer and eating sodium-rich diet farsan. Eat all food groups wisely, and you won't find these fattening.

Myth 6: Don't drink water while eating meals
Truth: This is the most commonly circulated myth. Water is the key for digestion, transportation of nutrients and effective absorption. Let's make it simple; think of your stomach as a mixer-grinder, which has to churn the ground food and get it ready to further break down for absorption. If your meal comprises thin dal, curries, buttermilk, with plenty of fluids to churn, your body may be able to do without water. But with today's lifestyle where we carry dry lunches to work such as roti with dry vegetables, and vegetable sandwiches, you will need to back it up with enough fluids.

Myth 7: Whey protein and supplements are pro-youth
Truth: Whey protein is very highly misunderstood. It's simply a muscle-building, quick-absorbing simplified form of amino acid, which is most effective in muscle repair. A basic whey supplement is not necessarily used to build muscles but to help you meet the protein requirements, especially since Indian meals are largely carbohydrate-based. As one gets older, the protein requirement increases and muscle-wasting speeds up. Hence, it's even more important for senior citizens to incorporate suitable whey protein supplements to help repair muscle, gain strength and maintain good stamina and health. It can be used correctly with any meal to meet your protein requirements for the day.

Myth 8: Fat burners and mono diets is the short cut to quick weight loss
Truth: Gaining and losing weight is the normal behaviour of human body but going for "fad diets" and pills for temporary weight loss is foolish. You can't achieve fat loss through these fat burners; in fact, they make you lose muscle and water, and fool you into temporary results you begin to believe in.

Myth 9: Eating organic food is healthier 
Organic foods are better for the environment as they are grown in natural environments and doesn't contain residues of the modern-day pesticides. But eating them doesn't necessarily mean you are consuming less calories. Organic cake, juices, chocolates and biscuits contain as much fat, sugar and salt as their non-organic counterparts. Don't be fooled by the label. The term 'organic' refers to farming methods used to produce a food item, and not to the nutrients found it. 

Myth 10: Dieting is enough to lose weight
"Overweight and obesity are misunderstood words. It is a chronic condition and there is no 'quick-fix' solution or treatment that is effective for all overweight or obese individuals," says Dr Manish Motwani, consultant bariatric surgeon, Jaslok Hospital. "Lifestyle modification (with a reduction of calorie intake and an increase in physical activity) is essential in all treatment strategies. All long-term programmes require at least some lifestyle changes. Positive changes in eating and exercise behaviour are essential for sustained reduction in weight. However, if you are extremely overweight you may have to undergo bariatric surgery," suggests Dr Motwani.

Other common weight-loss myths

>> Food eaten at night stops you from losing weight. Wrong. It’s not eating in the evening that stops losing weight, but eating in excess. In the end, it’s all about maintaining a zero balance in the calories and consumption sheet.

>> People inherit obesity: While scientists believe that children inherit obesity genes from their parents, it doesn’t explain how there is a sudden increase in obesity in the population. While genes have a role to play, our sedentary lifestyle is more responsible than the genes.

>> Cereal bars are lower in fat and sugar than chocolate or sweets. Wrong again. If you check the ingredients and calorie chart in a cereal bar, you will find just as much sugar as in chocolate. Read the nutrient chart before you buy any cereal bars.

>> Following a diet is not a punishment but simply a correction in your lifestyle and food choices. Whether at home or out, choosing wisely is the best option. Steamed or grilled foods, green salads and clear soups are wiser than eating homemade bhajiyas and chaats

- See more at: http://www.mid-day.com/articles/world-anti-obesity-day-common-weight-loss-diet-myths-busted/15791205#sthash.Ssvf9vSp.dpuf

GLOOCAL COMMUNICATIONS | Obesity in men can lead to infertility

Obesity in men can lead to infertility

Obesity in men can lead to infertility

Having a baby is the single most life-changing event in a couple's life. In fact, many excitedly go about planning every bit of it as they prepare to take on the mantle of parenthood. 

But with changing lifestyles and increase in stress levels, there's been an alarming rise in infertility. And obesity has been identified to be one of the major contributors to that. Obesity was once believed to affect a woman's chances of bearing a child, but recent cases now point in the direction of men as well in playing a part in infertility.
City doctors confirm the fact, stating startling facts that many couples seem to ignore. Dr. Kedar Ganla, fertility consultant physician at a reputed hospital, points out that 40 per cent of infertilityamong couples is caused by male obesity. "Obese tissue leads to the lowering of male hormone, i.e. testosterone, which directly affects fertility. The rising level of estrogen and the low level testosterone affects sperm making and production. Most of these health conditions arise from hypertension and diabetes, a by-product of obesity. In fact, uncontrolled diabetes leads to abnormal sperm production. Obesity also leads to low stamina, which reduces the urge of having sex," says Ganla.
He also reasons that obesity causes high amount of stress levels due to bad eating habits, poor physical activity and erratic works schedules. Its common knowledge now that stress makes one eat abnormally and cause weight gain. "A simple picture will tell you that an overweight man will not be able to play with the kid or get involved in a lot of physical activity which is a must for becoming a father," adds Ganla. Ever since male infertility has come into focus in a lot of cases, a lot of doctors are working on improvising the quality of sperms and suggest simple changes in lifestyle and medications for the couple.
IVF clinics, too, have come out with some sustainable solution for the same, where sperm counts can be regularised by following proper diet and exercise regimen. Dr Manish Motwani, a bariatric surgeon, says, "Apart from infertility treatment, obesity treatment and bariatric surgery plays a very important role in infertility and obesity management."

Motwani also adds, "Obesity affects sperm count directly. In fact it also leads to decreased libido and erectile dysfunction among males — both are important factors behind infertility. Moreover, it also leads to a reduced number of hormones as well as a direct effect on semen. This affects a man's chances having a relationship or a normal sex life."
Keep an eye on the BMI Obesity is determined by the BMI (Body Mass Index) level of a person, which is calculated as an average ratio of one's height and weight. A person with a BMI of 35 may be around 30 kgs overweight which poses a potential risk of infertility among males. According to Dr Manish Motwani, overweight men also have a higher cycle of cancellation rate when undergoing an IVF (in vitro fertilisation). This is why fertility doctors recommend overweight men to reduce weight before undergoing fertility treatments. "If all the weight lossoptions have been tried in the past without experiencing effective results, weight loss surgery should be considered for better chances of fertility. However, if a person can attain a decent BMI level within six months of following a healthy lifestyle with a balanced diet and regular exercise, a surgery can be avoided," says Motwani.
However, a weight loss surgery or bariatric surgery has proven to be the most effective for individuals with a BMI level more than 32.5 and suffering from associated medical conditions like infertility as well as associated complications like diabetes, hypertension, sleep apnoea. For morbidly obese people with a BMI rating of more than 40, a surgery is sometimes the only solution. Motwani also adds, "Depending on the type of weight loss surgery, a person can lose about 40 to 70 per cent of the extra weight within six-to-nine months after surgery. Ninety per cent are able to their weight loss for 10 years or more. This helps them stay healthy in the first few years of fatherhood, as well as in the years of bringing up their child.

Measures taken to regularise Fertility - Maintain a balanced lifestyle - Follow proper diet - Ensure you indulge in regular physical activity - Start with a fertility treatment only after considerable weight loss for better effects

How obesity leads to infertility - It reduces sperm count - Lowers levels of testosterone - Hypertension and uncontrolled diabetes deteriorates the quality of semen - Physical constraints in having a normal sex life - Lack of interest due to tiredness and stress

GLOOCAL COMMUNICATIONS | Dr Jayashree Todkar, bariatric surgeon | Bariatric surgery: Will your insurer pay?

Bariatric surgery: Will your insurer pay?

Opinion is divided on whether the surgery is cosmetic in nature or not. Most insurers say it is Vivina Vishwanathan 

Bariatric surgery, which is commonly referred to as weight loss surgery, is a treatment that most insurers do not cover because insurance experts, insurers and doctors differ on the surgery’s classification. Many lifestyle surgeries have become a norm rather than an exception. Here is an overview of bariatric surgery’s significance in insurance. Heavy weight “The term bariatric surgery was derived from the word ‘baros’, which means weight loss. The surgery is now known to normalize intestinal hormones and metabolism function. It also normalizes body balance, weight regulation, sugar and insulin regulation as well as metabolic syndrome. Hence, it is now known as metabolic and bariatric surgery. There are two types—restrictive (restricts food intake) and malabsorptive (absorbs fat),” said Dr Shashank Shah, head of department for metabolic and bariatric surgery, Fortis Hospital and S.L. Raheja Hospital, Mumbai, and president of Obesity and Metabolic Surgery Society of India (OSSI). In India, the number of bariatric surgeries has seen a steady increase—from about 3,500 in 2011 to over 10,000 in 2013, according to Metabolic Surgery Foundation of India. Such a surgery normally costs between Rs.1 lakh and Rs.5 lakh. Bariatric surgery is one of the ways to tackle diseases whose root cause is obesity. Obesity is calculated based on a person’s body mass index (BMI), which is a weight-height ratio. In India, a person with a BMI of over 32.5 is considered morbidly obese. According to bariatric surgeons, 11% of India’s population is either overweight or obese. “Obesity leads to many medical conditions such as diabetes, high blood pressure, lack of sexual desire, metabolic linkage to thyroid—all these lead to cardiovascular diseases,” said Dr Jayashree Todkar, bariatric surgeon and director of bariatric department of Dr L.H. Hiranandani Hospital, Mumbai, adding that among Indians, diabetes is the most common disease caused by obesity. Grey area Many Indians may be opting for bariatric surgery—Todkar, for instance, has treated over 10,000 obese patients since 2004, of whom 1,800 underwent this surgery—but insurance for it is a grey area. Firstly, there is a conflict in opinion on how to view bariatric surgery—cosmetic or non-cosmetic. “The government has said that obesity is a disease and bariatric surgery is a non-cosmetic surgery,” said Dr. Ramen Goel, senior metabolic and bariatric surgeon, Hinduja Healthcare at Khar, Mumbai. The central government’s health scheme has been offering reimbursement to patients for bariatric surgery since November 2013. On 21 August, the Medical Council of India stated in a letter that “bariatric surgery is gastrointestinal non-cosmetic surgery under the rubric of surgical gastroenterology and not plastic surgery”. However, insurance experts don’t agree. They say that insurers consider it as cosmetic surgery. “Chances of getting an insurance claim approved are very low. If you take a look at the bariatric surgery cases in India, almost 95% of them are cosmetic in nature. So, generally, insurers refuse to accept a claim for such a surgery,” said Kapil Mehta, managing director, SecureNow Insurance Broker Pvt. Ltd. Another reason why the surgery is usually not covered is that many insurers exclude any surgery related to obesity. Obesity is not covered; the only exception is if the situation is life threatening. “There was one gentleman who came to me five years ago. He weighed 120 kg and needed a surgery. Since the insurer denied him mediclaim on the grounds that it was for weight loss, he could not undergo the surgery. Five years later, he was back, but now he weighed 180 kg, had full grown diabetes and a breathing problem. This time, he got corporate insurance. Why should the patient wait for the disease to worsen when it can be cured at an earlier stage?” said Todkar. There are a few insurers that provide cover. “We provide cover for bariatric surgery if it is done for medical purposes. We do a thorough due diligence and if proved that it is not for cosmetic reasons, we cover the surgery,” said Sanjay Datta, chief-underwriting and claims, ICICI Lombard General Insurance Co. Ltd. In the past 2-3 years, insurers have been providing cover, but under certain clauses. Shalini Jadhav, a 32-year-old homemaker in Mumbai has insurance cover for bariatric surgery. At 89.6 kg and BMI of 39.5, she was suffering from back pain, lethargy, tiredness and breathlessness while walking and climbing. “I had vitamin B12 and D3 deficiency, dyslipidemia, hyperinsulinemia, low calcium level and fatty liver. I was suggested metabolic and bariatric surgery and underwent the surgery in February this year. My insurer covered it,” said Jadhav. The insurance company was ICICI Prudential Life Insurance Co. Ltd, and it considered Jadhav’s surgery to be done in a life threatening situation. Last year, claims from four of Todkar’s patients were accepted. However, she points out that there have been instances where despite a genuine case for surgery, insurers rejected the claims. “Generally, no insurer provides a cover for bariatric surgery, as it’s treated as a cosmetic surgery,” said Yashish Dahiya, chief executive officer and co-founder, PolicyBazaar.com. “There are a couple of companies, including Cigna TTK and New India Assurance, that might cover the surgery, but the coverage would be taken into consideration only if it’s a life threatening situation. This, too, only if the insured member is healthy and doesn’t have a high BMI during the proposal of the policy,” he added. So, it is also your responsibility to prove that the surgery was done for a medical condition to get a claim. “Normally, if the surgery is done for medical purposes and is prescribed by the doctor, then you can get mediclaim for the surgery. Insurers will have to abide by it. However, if the sole purpose of the surgery is weight loss, then you can’t get a claim,” said Rahul Aggarwal, chief executive officer, Optima Insurance Brokers Pvt. Ltd. What should you do If you specifically need this cover, your options are limited as only a few companies offer it. Check for specifications before buying the health insurance policy. Also, if you indeed need a bariatric surgery, check with the insurer before agreeing to it.

Read more at: http://www.livemint.com/Money/dHhqdKqE3aVH6oBTV3hjFJ/Only-a-few-insurers-cover-bariatric-surgery.html?utm_source=copy

50% Mumbai collegians are overweight and obese: Study

The survey found 42% subjects had abnormal waist circumference. “The most shocking aspect was that 58% of those surveyed didn’t consider obesity a disease,” added Todkar, who consults at L H Hiranandani Hospital in Powai.

MUMBAI: A survey among nearly 10,000 city collegians between 18 and 25 shows nearly half (46%) are either overweight or obese, raising major concerns about the health of the nation's youth.

"We not only found one out of every two youths in our survey unfit, we realized they don't link obesity to diseases,'' said Dr Jayashree Todkar, who conducted the survey. "Obesity to them is a problem with size and shape.'' Obesity is a leading cause for cholesterol problems, hypertension, diabetes and cancer, among many others.

"If the youth are overweight, it is a disaster waiting to happen. These young people will end up with multiple diseases at a younger age in comparison to previous generations," said Dr Ramen Goel. No single study to ascertain obesity levels in India is available, but city-centric surveys have thrown up diverse figures ranging from 30% to 70%.

Experts are not surprised that almost half of Mumbai's youth are plus-size. "Affluence in metros such as Mumbai leads to over-gadgetization that promotes sedentarism, which, in turn, fuels obesity," said endocrinologist Dr Shashank Joshi. Instead of physical activity such as running or sports, many of today's youths prefer to "only exercise" their eye and finger muscles over their smartphones, he added.

Dr Todkar, head of the Maharashtra chapter of the Association for Advanced Research in Obesity, conducted the survey among students, ranging from newcomers to post-graduates, of 15 colleges between February and April 2014. "While talking to some of the youths coming to us with obesity-related problems, we realized many didn't realize the correlation between obesity and family history and other diseases,'' she said.

The survey found 42% subjects had abnormal waist circumference. "The most shocking aspect was that 58% of those surveyed didn't consider obesity a disease," added Todkar, who consults at L H Hiranandani Hospital in Powai.

Dr Anoop Misra, an endocrinologist from Delhi who has conducted several studies on levels of obesity in children and grown-ups, said the growing acceptance of plus-sizes is a disturbing aspect. "Nowadays, it is normal to be overweight. In my clinic, patients wonder why they should lose weight when everybody is overweight. If you see more fat people in society, you will believe that being fat is normal,'' he said.

The new survey also found that only 6% of the youths took up physical pursuits such as sports or running. "Most of those interviewed felt travelling in a city like Mumbai leaves them with no time or energy for exercises," said Todkar.

But a structured physical regimen would go a long way in checking the obesity epidemic. "Our schooling system induces stress which is worsened by the lack of physical exercise, too much of junk food and TV viewing," said Joshi. He feels the education system should be overhauled to improve health. "Children should have more sports periods and must be taught about health eating habits."

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Dr Anil heroor

http://www.mid-day.com/articles/nigerian-can-eat-again-after-doctors-construct-a-new-food-pipe/15080068

When the 45-year old Nigerian national bought a cough medicine from a store back home, little did he know that it would end up damaging his food pipe, making him unable to swallow food or even his saliva for months. However, Nuruddin Shittu can finally see light at the end of the tunnel as Mumbai doctors constructed another food pipe using his forearm’s skin tissues, and replaced it with the damaged one. - See more at: http://www.mid-day.com/articles/nigerian-can-eat-again-after-doctors-construct-a-new-food-pipe/15080068#sthash.77xwlecK.dpufWhen the 45-year old Nigerian national bought a cough medicine from a store back home, little did he know that it would end up damaging his food pipe, making him unable to swallow food or even his saliva for months. However, Nuruddin Shittu can finally see light at the end of the tunnel as Mumbai doctors constructed another food pipe using his forearm’s skin tissues, and replaced it with the damaged one. - See more at: http://www.mid-day.com/articles/nigerian-can-eat-again-after-doctors-construct-a-new-food-pipe/15080068#sthash.77xwlecK.dpufWhen the 45-year old Nigerian national bought a cough medicine from a store back home, little did he know that it would end up damaging his food pipe, making him unable to swallow food or even his saliva for months. However, Nuruddin Shittu can finally see light at the end of the tunnel as Mumbai doctors constructed another food pipe using his forearm’s skin tissues, and replaced it with the damaged one. - See more at: http://www.mid-day.com/articles/nigerian-can-eat-again-after-doctors-construct-a-new-food-pipe/15080068#sthash.77xwlecK.dpuf

Using stem cells, doctors restore 14-yr-old’s vision

At 65 per cent, the vision in Omkar Babhat’s right eye is increasing steadily after the stem cells were transferred from his healthy left eye

Babhat had accidentally sprayed glass-cleaning fluid into his eye while struggling to open the cap, which meant he could just see an occasional flash of light, and nothing more MUMBAI While the past four months have been painfully slow for 14-yearold Omkar Babhat, the increasing vision in his right eye, now a healthy 65 per cent, has been a growing relief for him and his parents, thanks to a novel method of surgery using stem cells from his left eye. In March last year, the Airoli resident had accidentally sprayed glass-cleaning fluid into his eye while struggling to open the cap, which had reduced his vision to seeing the occasional flash of light, and nothing more. After consulting several eye doctors, the Babhats realized that a complete corneal transplant was not possible in Omkar’s case as chemical burns had caused damage to his corneal limbus — the junction where the black and white portions of the eye meet. It was only when they approached corneal surgeon Dr Suresh Palanisamy in October 2013 that hope dawned for the family. Palanisamy suggested they go in for Simple Limbal Epithelial Transplantation (SLET) — a process wherein healthy stem cells are harvested from the corneal limbus of the undamaged eye and transplanted to the damaged cornea. “The patient had suffered ocular surface damage due to severe chemical burns. The cornea, which is normally clear, had turned opaque blocking the vision. There was also accumulation of scar tissue due to the burns,” explained Palanisamy, who operated on Omkar at the Fortis Hospital in Mulund . The two-hour-long procedure involved removing 2 mm of stem cell tissue from Omkar’s left eye. After that, the scar tissue accumulated in the right eye was carefully removed. “A layer of amniotic membrane was then stuck onto the damaged cornea using a special glue. The stem cell tissue obtained from the healthy eye was then cut in 10 tiny bits, that were spread on the amniotic membrane and affixed with the same biological glue,” said Palanisamy. He added, “The amniotic membrane (the sac in which a foetus develops) promotes stem cell multiplication and dissolves gradually. As the healthy stem cells multiply, the opaque cornea started clearing up and Omkar began regaining his vision. It will get better over the next three months.” Remembering the horror and frustration of the initial days after the accident, Omkar’s father Shivaji said, “We immediately splashed water into the eye and consulted an ophthalmologist who prescribed medicines and eye drops, but the condition of his eye only worsened with time, and led to a complete loss of vision. He could only see lights flashing. Now, he can see everything and even read.” WHAT IS SLET? Simple Limbal Epithelial Transplantation (SLET) is a procedure wherein limbal stem cells from the undamaged eye are transplanted to the damaged one to restore its vision. About five years ago, the process of multiplying the limbal stem cells was carried out in a petri dish. In 2012, doctors from the L V Prasad Eye Institute in Hyderabad were the first to carry out the procedure directly on the damaged eye.

Dad’s alertness saves infant twins’ eyes from rare cataract damage

The babies had cataract in both their eyes due to a congenital condition that affects five out of 10,000 live births

Since the babies' eyeballs are tiny, they will have to wear special spectacles till they are five years old.

For the past two months, the Agraharis were a worried lot. Their twin boys - born in October last year - had been detected with congenital cataracts in both eyes sometime in December, a condition that affects five out of 10,000 live births and leads to visual impairment if not detected early.

In fact, it was Sunit Agrahari, their father, who spotted the tell-tale spots of white in their eyes that kept getting bigger with time. Soon, Agrahari had ascertained that the twins were not reacting to light. "We could feel that something was amiss," said Agrahari, aresident of Vidyavihar.

If possible, the doctors at Fortis Hospital where Agrahari took his sons, Mihir and Manav, for treatment were even more on tenterhooks. Two month-old infants meant cataract surgeries on four eyes, scaled down to micro levels. The doctors decided to operate on the babies one by one, with a two-week gap between each eye.

"The babies had cataract in both their eyes, and that too in the centre, which was obstructing light. Had it not been treated, they would have been visually impaired," said Dr Anand Subramanyam, a vitreo-retinal surgeon who operated on them along with ophthalmologist Dr Girija Suresh, at Fortis.

"To avoid infection, we did one eye at a time and gave a considerable gap before performing the next. The surgeries were high-risk as the patients were so tiny. Administering anesthesia was difficult, but operating on such a small area in the eye was even more challenging," he said, adding that bilateral cataracts in twins was rare as well.

Doctors made a pair of tiny holes in each eye and used a surgical instrument to cut and aspirate the cataract. Then, a specialised instrument was used to make the keyholes miniscule which helped to avoid use of sutures.

Generally, an intraocular lens is implanted in adults who undergo cataract surgeries but since the babies' eyeballs are tiny, doctors have given them special spectacles which they will have to wear till they are about five years old.

"The only difficulty is ensuring that the babies are constantly wearing their spectacles," said Agrahari, adding that the surgeries cost him Rs 90,000.

According to Dr Nagendra Shah, an eye specialist with Bombay Hospital, congenital cataracts are generally caused due to poor antenatal care, infection in mother during pregnancy, poor hygiene. "The root cause may be genetic or hereditary," said Shah.

What is congenital cataract?

Cataract is clouding of the lens in the eye, affecting vision, and a congenital cataract occurs at birth. Medical experts say that 5 in per 10,000 live births may suffer from congenital cataracts, but not all expand and lead to visual impairment. 

Dr Aashish Arbat, Orthopedic Surgeon

Patient walks within 1 hours of knee replacement surgery

~ Dr Aashish Arbat, Orthopedic Surgeon adopts unique surgical and pain management approach to ensure Rapid Recovery After Surgery (RRAS) ~

Fortis Hospital has successfully performed total knee replacement surgery on 71 year old man from Kalyan. Dr Aashish Arbat, Knee & Hip Replacement Surgeon, Fortis Hospitals Kalyan performed the surgery on 71 year old Mr. Baburav Chaudhari who was suffering from end-stage knee osteoarthritis. Surgery was performed with minimal blood loss - a combination of advanced muscle sparing surgical exposure,  specialized mix of navigation techniques and patient-specific implants. Patient walks within 1 hour of knee replacement surgery without taking any support.

Mr. Baburav Chaudhary who works as a car driver since 1961 had a sudden pain in his right leg. His pain lasted for more than two month & was unbearable that he was not able to walk or go for work.

After going through his x-ray report Dr Arbat confirmed him end-stage knee osteoarthritis and suggested Knee replacement need in future. Family was aware of benefits of knee replacement surgery and decided to undergo surgery to get pain free life.

“Patient was very confident about his fast recovery; it does happen very few time when patient show confidence with doctor before doing knee or hip surgery“Says Dr Arbat.  This helped Dr Ashish Arbat, Joint Replacement Surgeon who has conducted several knee replacement surgeries that have enabled patients to walk within a few hours of the operation and recover with minimal pain after at Fortis Hospital in Kalyan.

Knee replacement surgery or knee arthroplasty involves replacing a damaged, worn or diseased knee with an artificial joint.

The most common reason for this surgery is severe osteoarthritis. Osteoarthritis is the leading cause of disability in India and affects over 15 million Indians every year. In addition to a rapidly ageing population, this most prevalent form of arthritis is becoming increasingly common among people in the age group of 35-55 years.

In usual knee replacement surgeries, post-operative pain is the biggest impediment to early discharge and recovery. Pain is also the most important reason why a large number of patients choose to endure the immobility rendered by severe osteoarthritis instead of getting their damaged joint replaced.

Dr Ashish Arbat, Knee & Hip Replacement Surgeon, at Fortis Hospital Kalyan, however, has crafted a unique approach to ensure Rapid Recovery after Surgery (RRAS). He combines:

·         Skin glue – All surgeries are stitch-free.

·         No drains – The bleeding is controlled before closing the wound instead of draining it after.

·         Catheter - It provides a low dose anesthetic directly to the area.

·         Common, non-drowsy pain medication – Crocin and Voveron

·         Extensive counseling – allowing patients to feel the implants, showing pictures of the surgery, familiarization with physiotherapy, free interaction with patients already admitted at the hospital, confidence-building

Minimally Invasive TKR using subvastus muscle sparing approach with rotating platform design PS 150 knee implant was used. In 20 min of post surgery Mr. Chaudhari was made to move his operated Rt.  Limb & about 1hr he was able to walk without anyone support. Normally it takes minimum 48 hrs to give such a type of physio activity &  3 weeks to make patient walk with full weight bearing. These kinds of patient with high level of motivation are fit to technique called “Rapid Recovery After Surgery (RRAS)”.  We counsel each and every patient before & after surgery and facilitate the entire rehabilitation program for the patient Says Dr Arbat